The present application is related to a patient support apparatus that includes a control system for predicting and mitigating events adverse to the health of a patient supported on the patient support apparatus. More specifically, the present application is directed to a patient support apparatus having a control system that gathers information regarding the patient supported on the apparatus, the environmental conditions in the room in which the patient support apparatus is located, and operational characteristics of the patient support apparatus and acts on that information to predict adverse patient events and mitigate those risks.
A patient in a care facility such as a hospital, for example, is often in a compromised medical condition and susceptible to developing complications. Injury sustained while in a care facility or the development of complications due to an extended presence in a care facility result in significant costs to the care facility and the patient. When these injuries or complications are considered preventable, the care facility acquired conditions may not be covered by a patient's insurer or other payers such as Medicare, for example. In an effort to prevent such injuries and complications, various protocols are implemented by the management of the care facilities to mitigate the risks. For example, the use of prophylactic antibiotics after surgery may be a standard institutional practice to mitigate the risk of surgical infections. Patients who are at risk of falling when moving unassisted may be identified as fall risks and certain protocols may be implemented to reduce the opportunity for the patient to move about the room unassisted.
In response to the desire of healthcare facilities to reduce risks, sensor systems to detect the status of various components of a patient support apparatus, such as a bed, for example, have been developed to help assure that protocols are being met. For example, patient position monitoring systems monitor the movement of a patient on a patient support apparatus and alarm if the movement is excessive or a patient has exited the bed. It is also known to implement alarms for certain bed positions, such as the amount of elevation of the head section of the bed to assure that a patient is positioned with her upper body at an appropriate angle relative to gravity when various therapies are being delivered. Also, the patient support apparatus may include sensors that detect when a side rail is in an appropriate position or that the brake system of the patient support apparatus is properly engaged. This information is provided to a central monitoring system, such as a nurse call system, so that deviations from the appropriate conditions may be monitored by the central system and alarms generated if a protocols are not being followed.
The use of these bed status variables requires that certain conditions be pre-established in the central monitoring system. For example, if the patient is a fall risk, the central monitoring system must be configured to monitor for side rail position and bed exit status for the particular patient support apparatus on which the fall risk patient is positioned. The same is true for other protocol monitoring conditions, the system must be configured for a particular patient, and the caregivers must modify the alarm conditions based on the particular protocols implemented for a given patient. Because of the required active intervention of the caregivers, protocols are often directed to particular classes of patients without regard to any patient or environmental based mitigating conditions. A change in status of a particular patient requires the caregiver to implement modified protocols and update any monitoring conditions that may need to be modified due to the change in the patient's condition.
Several conditions are of significant interest to caregivers based on the statistical incidence of care facility-based injuries or complications. For example, there is strong statistical support for a need to mitigate the risk of falls in patients who are 65 years or older. Other patient populations may also be at risk of falls depending on other medical conditions that are normally assessed at the time of admission into a care facility. However, as with any statistic, there are exceptions that mitigate the risk even in at risk populations. As a result, applying a “one-size-fits-all” fall prevention program based on age may not provide a patient who has a low risk with the appropriate care for that particular patient. A patient who has mitigating conditions which significantly reduce the risk of fall, even though their age places them in a high-risk group, may be negatively impacted in their recovery if the highest fall prevention protocol is applied to that particular patient. Generally, a fall prevention program requires a patient to be assisted when ambulating. For a patient who feels healthy and is at low risk of falling, such a protocol may result in the patient being noncompliant to other protocols.
Other risks include facility-acquired infections, such as infections acquired after a surgery. Patients who are positioned on the patient support apparatus for extended periods may also develop pressure ulcers on their skin. Various factors may result in a compromised skin condition that increases the potential of these nosocomial pressure ulcers. Another significant risk for bedridden patients is the development of Ventilator-Associated Pneumonia (VAP). Several factors may impact the likelihood of a particular patient acquiring a particular complication or suffering a particular injury while in a care facility.